Frail older adults are those that have unintentional weight and muscle loss, weakness, slowness and a low activity level (Fried et al. 2001). Many have difficulty performing and completing daily tasks and require the assistance of a caregiver. Among other challenges they may face on a daily basis, preparing and consuming a healthy diet can be difficult for this group. If frail older adults have trouble preparing and consuming a healthy diet and meeting their nutritional needs, malnutrition may progress.
Frail older adults may also face challenges from age-related conditions and diseases that may decrease their quality of life and make preparing and consuming a healthy diet difficult. Most often, the frail older adult who is able to live at home needs the assistance of a caregiver with everyday tasks like preparing meals (Cleggs et al. 2013).
Frail older adults may face unique challenges that may interfere with meeting their nutritional needs. For example, they may have problems chewing and swallowing. They may also have gastrointestinal issues, such as constipation and loss of appetite. Weakness from muscle loss may also further impair their ability to complete physical tasks, such as cooking. Challenges like these may lead to discouragement, decreased food consumption, and irregular eating patterns, which can further lead to various nutrient deficiencies. In order to help this population overcome some of the challenges of preparing and eating a nutritious diet, caregivers need access to ideas and tools that will help them provide adequate nutrition to the frail older adult. Simple, nutritious snacks are easy to prepare and consume and are a great way to add nutritious foods to their diet.
Nutrition for the Frail Older Adult
As people age, their nutrient needs change. Certain vitamins and nutrients become increasingly important, such as calcium and vitamin D for bone health and protein for healing and muscle health. Malnutrition is more likely to occur in the homebound, frail older adult than in the healthy older adult because the homebound older adult often has more difficulty accessing healthy foods or grocery stores. They are commonly homebound because of disability or illness, and these conditions make preparing meals a challenge. To achieve optimal health, it is important to consume a variety of foods from all of the food groups, which helps to ensure that one gets the nutrients one needs. Consuming snacks that provide key nutrients and taste good is a simple and important way to provide the frail elderly adult with nutrients that are critical to their health.
Protein is important for all individuals, but it is especially important for the frail older adult. Protein has many functions. It repairs cells, maintains and replaces tissues, and manufactures hemoglobin (red blood cells that carry oxygen). It is essential to blood clotting. It also produces antibodies to fight diseases and illness. Good sources of protein include meat, poultry, fish, dairy products, and legumes.
Calcium and Vitamin D
Although all vitamins and minerals are necessary for optimal health, calcium and vitamin D are very important for the frail older adult. Adequate calcium and vitamin D are needed to maintain bones. More vitamin D is needed from the diet as skin synthesis declines with age. There are ways to add more calcium and vitamin D to the diet. Dairy foods, particularly milk, yogurt, and cheese, are high in calcium. Other good sources include calcium-fortified versions of orange juice and soy beverages. Food sources of vitamin D include fatty fish, milk, and some yogurts, as well as fortified breads and cereal. However, many breads and cereals do not have added vitamin D, so it is important to check the label.
Easy Snack Ideas
Making wise snack choices helps to ensure that frail older adults meet their nutrient needs. Here are some simple, nutritious snacks that are appropriate for the frail older adult. They are easy to chew and swallow as well as easy to prepare, and they taste good! When planning snacks for the frail older adult, it is important to incorporate a variety of healthy food choices. This ensures that snacks are providing a balance of nutrients.
Deviled eggs: Deviled eggs are a great source of protein. Start by boiling the eggs until hard (ten minutes). Drain the eggs and then cool with cold water or refrigerate them. Place the eggs on a clean cutting board. Remove the shells and slice the eggs in half lengthwise. Remove the yolk with a spoon and place the yolks in a dish. Add mayonnaise to the yolks and stir until moist and creamy. Spoon the yolk mixture into the egg hollows and sprinkle with paprika. Serve chilled.
Cottage cheese with canned fruit: Cottage cheese is a snack that is very soft and easy to eat. It also provides a good source of protein. Canned pears or peaches with light syrup are tasty and give the cottage cheese a different flavor. Open the canned fruit and drain. Next, slice the fruit into bite-sized pieces and combine with a few tablespoons of cottage cheese. Mix well and serve chilled.
Flavored milk: Flavored milks, such as chocolate or strawberry, provide protein, calcium, vitamin D, and energy and are a quick, easy, and tasty snack. Shelf-stable, single-serving versions are particularly convenient.
Yogurt with fruit: Greek yogurt is a good snack option for the older adult and provides a source of protein and calcium. Serve half a cup of plain or flavored yogurt topped with fresh berries
Milk pudding: Pudding is a tasty and convenient snack to keep on hand. Pudding can be bought as shelf-stable, individual servings or as fresh options that require refrigeration. In addition to the commonly available flavors, such as vanilla, chocolate, and butterscotch, traditional favorites of the older adult, rice and tapioca, are also available.
Blended smoothies: Smoothies are simple to prepare with lots of flavors and ingredients to choose from. A basic smoothie starts by pouring a cup of milk into a blender. Add ½ cup of yogurt or ice cream and fresh fruit. You can add any fruit you would like, but try to choose fruits that blend well, like bananas or berries. Drizzle honey on top to add some sweetness. Blend on high until smooth. Pour and serve.
Cheese: Cheese is tasty and simple to prepare. Block cheddar, Swiss, and mozzarella cheese are good options, but also try the many varieties of specialty cheeses. Cut the cheese into bite-sized cubes or purchase packaged cheeses that are already cubed.
Ice cream with strawberry drizzle: Ice cream is a delicious treat that most people simply cannot resist. Ice cream comes in a variety of flavors and also in differing fat contents. Premium ice creams are usually higher in fat but also are more flavorful. Try serving puréed strawberries drizzled over ice cream.
Tuna salad: Tuna in a can is inexpensive and simple to prepare. If sodium is an issue, the tuna can be rinsed. For a quick tuna salad, just open the can, drain, rinse, and mix with mayonnaise and seasonings. Tuna salad can be served with soft crackers.
A healthy diet that tastes good is very important for the frail older adult. Ailments may make it difficult to prepare healthy meals, and snacks become much more important in ensuring optimal nutrient intake. Often, a caregiver is needed to assist with daily tasks like shopping and food preparation. Serve delicious snacks that are easy to prepare and affordable, and that also can meet the nutritional needs of the frail older adult.
Clegg, A., J. Young, S. Iliffe, M. O. Rikkert, and K. Rockwood. 2013. "Frailty in elderly people." Lancet 381 (9868):752–62. doi: 10.1016/s0140-6736(12)62167–9.
Fried, L. P., C. M. Tangen, J. Walston, A. B. Newman, C. Hirsch, J. Gottdiener, T. Seeman, et al. 2001. "Frailty in older adults: evidence for a phenotype." J Gerontol A Biol Sci Med Sci 56 (3):M146–56.